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Home My WebLink AboutM051718 BOHJEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, May 17, 2018 Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 Board Members Kate Dean, County Commissioner District #1 David Sullivan, County Commissioner, District #2 Kathleen Kier, County Commissioner, District #3 Ariel Speser, Vice -Chair, Port Townsend City Council Sheila Westerman, Citizen at large Kees Kolff, Hospital Commissioner, District #2 John Austin, Chair, Citizen at large Staff Members Thomas Locke, Health Officer Vicki Kirkpatrick, Public Health Dir Stuart Whitford, Env. Health Dir Veronica Shaw, Public Health Deputy Dir Michael Dawson, WQ Manager Jenny Matter, Clerk of the Board Chair John Austin called the May 17, 2018 meeting of the Jefferson County Board of Health to order at 2:30 p.m. A quorum was present. Members Present: David Sullivan, Kees Kolff, Kathleen Kler, Kate Dean, Sheila Westerman, John Austin Members Excused: Ariel Speser Staff Present: Thomas Locke, Stuart Whitford, Vicki Kirkpatrick, Jenny Matter APPROVAL OF AGENDA Chair Austin recommended moving New Business Item 1: 2018 Jefferson County Public Health Food Safety Awards to take place after Public Comment. Chair Austin asked for approval of the Agenda of the May 17, 2018. Member Kathleen Kler motioned to approve the agenda as amended. The motion was seconded by Member Kate Dean. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Austin asked for approval of the minutes of the April 19, 2018 meeting of the Jefferson County Board of Health. Member Kate Dean motioned to approve the minutes. The motion was seconded by Member Sheila Westerman. No further discussion. The motion passed unanimously. Page 1 of 7 PUBLIC COMMENTS Chair Austin opened the public comment period. John Tevis of Port Hadlock spoke about his neighbor who maybe dumping raw sewage on his adjacent property and his frustration over the lack of code enforcement in Jefferson County. Greg Brotherton of Quilcene spoke in favor of adopting the Washington State Department of Health Recommended Standards and Guidance for Performance, Application, Design and Operation & Maintenance of Water Conserving On-site Wastewater Treatment Systems and encouraged the Board to consider pit privies. Sherry Adcock of Brinnon spoke in opposition to House Bill 2420 concerning State Board of Health rules regarding on-site sewage systems. Chair Austin closed the public comment period. Stuart Whitford, Environmental Public Health Director, announced the 2017 Outstanding Food Safety Awards. Each recipient was named and applauded. Award recipients in attendance were Adam Burns (Ferino's Pizza), Robert Gray (Port Townsend Senior Nutrition), Stacey Larsen (Port Townsend School District), and Pippa Mills (Pippa's Real Tea). OLD BUSINESS AND INFORMATIONAL ITEMS 1. Jefferson Healthcare (JHC) Update Kees Kolff provided an update on new staff and average time to schedule appointments. He also reported that: 1) the dermatology and cardiology build out project was approved and construction will begin mid-June, 2) 15 providers have signed up for medically assisted treatment (MAT) training for opioid use disorder, which the Salish BHO will help fund, 3) they received the 2018 Patient Safety Excellence Award from Healthgrades, and 4) he attended the Washington State Hospital Association Patient Safety Summit for CEOs and Board Members which featured a half-day training on reducing burn -out by Dr. Sexton from Duke University (https://today.duke.edu/2016/02/resilience). 2. Insights from Population Health Science to Inform Research on Firearms Dr. Tom Locke, Health Officer, said Congress is now allowing the CDC to do public health research on gun violence. Independent groups are broadening the scope of research to include effects of nonfatal injuries related to gun violence and epidemiological features of homicides and suicides. He also provided statistics for suicides and homicides, including mass shootings. Kathleen Kler added that the benefits of an authorized and well -regulated gun club are to teach people how to safely use and store firearms. Page 2 of 7 Kitsap County Request re: "DisposeRX" Medication Disposal Packs Dr. Tom Locke informed the Board HB 1047 to create a system for safe and secure collection and disposal of unwanted medications passed in the last legislative session. Although it won't take effect until 2020, counties that passed their own ordinances have taken approximately 2 years to fully implement. Therefore, a local ordinance for Jefferson County is not recommended. Dr. Locke also informed the Board that Kitsap County is encouraging Walmart to discontinue distributing DisposeRx medication disposal packs as it is potentially unsafe to dispose of some medications in the local waste stream and unknown if it truly neutralizes the medication. The Board questioned if Clallam County is aware of Kitsap's position and what department was responsible for initiating the legislation. Stuart Whitford, Environmental Health Director, added that the State Department of Environmental Health is the lead agency and minimal involvement is required from local health jurisdictions. 3. Transformation Talk: Creating Connections — Health Care and Housing Dr. Locke told the Board about a Transformation Talk which focused on a Jefferson County housing initiative. Transformation Talks are archived at https•//www doh wa gov/ForPublicHealthandHealthcareProviders/HealthSystemsTransformation /TransformationTalks and can be viewed any time. NEW BUSINESS 1. Public Hearing: Adoption of Washington State Department of Health Recommended Standards and Guidance for Performance, Application, Design and Operation & Maintenance of Water Conserving On-site Wastewater Treatment Systems into Jefferson County Code Chapter 8.15, Onsite Sewage Code Stuart Whitford provided a brief introduction to the proposed action of adopting the state guidance for on-site wastewater treatment systems, including composting toilets, incinerating toilets, vault toilets, greywater systems, etc. Although these systems have been available to install for some time, there has not been sufficient outreach to inform the public. Adopting the state's guidance is the first stage in educating the public, designers, installers, maintenance specialists, pumpers, etc. about the availability of public domain systems and the waiver process. Mr. Whitford asked the Board to approve the adoption of all but subsection A4 (Pit Privies) of the Washington State Department of Health Recommended Standards and Guidance for Performance, Application, Design and Operation & Maintenance of Water Conserving On-site Wastewater Treatment Systems (2012) into Jefferson County Code Chapter 8.15, Onsite Sewage Code. Mr. Whitford requested that subsection A4: Pit Toilets not be adopted for two reasons: 1) Policy #4-88 prohibits issuing permits for pit privies, and 2) Pit privies are known to contaminate shallow ground water with nitrates and chlorides, in which both the development and onsite sewage codes have been designed to minimize the contamination by these elements. Page 3 of 7 The Board had questions and comments about privies that were permitted prior to 1988, composting toilets, code enforcement, variances in site specific hydrology, and the cost of demonstrating compliance for alternative systems and waivers. Chair Austin opened the public comment period. Paul Ruben of Nordland spoke in favor of composting and contained toilets and explained why he thought pit privies would not meet scientific stringency. Sherry Adcock of Brinnon spoke in favor of composting toilets and asked if Sani-cans were going to be prohibited. John Tevis of Port Hadlock spoke about the lack of enforcement for current issues and concern over the ability of the county to enforce regulations for pit privies. Amanda Funaro of Port Townsend spoke in favor of continuing to prohibit pit privies and stressed the importance of maintaining good relationships between residents and the county. Greg Brotherton of Quilcene spoke in favor of allowing pit privies so more residents would become compliant with county regulations. Megan Selva of Nordland spoke in favor of composting toilets. Chair Austin closed the public comment period. The Board discussed their concerns over changing county policy to allow pit privies. Dr. Locke told the Board he felt it was a step backwards to allow pit privies as the prime directive of the onsite sewage code is to prevent human disease transmission and pit privies do not often disinfect the human waste to the same degree that on-site sewage systems and composting toilets do. He also informed the Board that the onsite sewage code regulations are subject to waiver if the property owner can demonstrate they meet the intent of the code through alternate means. Thus a pit privy could be approved, by waiver, in situations where no other alternative is feasible. Shelia Westerman said the Board has worked hard to educate people about the importance of properly treating septage to protect the environment and it would be a huge step backwards to allow pit privies after having them prohibited for thirty years. Kathleen Kler commented on the progress made by clarifying terms and understanding how septage breakdown occurs under varying conditions. She noted the importance of educating the public. Kees Kolff spoke in favor of using composting toilets over pit privies. Page 4 of 7 Kate Dean spoke in favor of allowing pit privies with strict performance measures, but questioned if there was the capacity available to do so. Chair Austin spoke in favor of using waivers instead of creating checklists for pit privies. Mr. Whitford explained the process for class B waivers and commented on the expense of complying with environmental regulations for people with limited incomes. David Sullivan spoke in favor of adopting the guidelines, noting it would help educate residents about the options they have in Jefferson County. Member Sheila Westerman motioned to (1) adopt alternatives one and two in which the Board of Health directs staff to amend Jefferson County Chapter 8.1.5 Onsite Sewage Code by incorporating the current state Water Conserving OSS Guidance into the code, further publicize and educate citizens on existing regulations and guidance that enable them to install water conserving OSS and grey water systems, and use existing waiver authority to evaluate and potentially approve water conserving OSS technologies that are non -propriety, and (2) uphold Policy Statement Number 4-88 issued June 1511, 1988. The motion was seconded by Member Kathleen Kler. No further discussion. Member David Sullivan, Chair Austin, Member Kees Kolff, Member Sheila Westerman, Member Kathleen Kler voted for the motion. Member Kate Dean voted against the motion. Vice - chair Ariel Speser was not present at the meeting. The motion carried. 2. Amendment of Case Scanning/Technology Fee to Fund Annual Maintenance of New Permit Database System, Create Dedicated Reserve Account for Modifications and Replacement, and Fund Scanning of Environmental Health Documents: Call for Public Hearing June 21, 2018 Mr. Whitford summarized the process of selecting a new permit database system and how the cost to maintain and, eventually, replace the system was calculated. A 5% surcharge on all fees charged by the Department of Community Development, Public Works, and Environmental Public Health should cover the annual maintenance fees and replace the system after 20 years. Mr. Whitford said he is looking at alternatives for lowering the fee for schools, churches, and other non -profits, particularly for temporary food permits held for fundraising purposes. Mr. Whitford asked the Board of Health to call for a public hearing on June 21, 2018 to amend the case scanning technology fee to fund annual maintenance of the new permit database system, create a dedicated reserve account for modifications and replacement, and fund scanning of environmental health documents. Member Kate Dean motioned for Public Health to hold a public hearing on June 21, 2018 to amend the case scanning technology fee. The motion was seconded by Member Sheila Westerman. The motion passed unanimously. Page 5 of 7 3. Oral Health Care Access and System Transformation Initiatives; Jefferson, Clallam, and Kitsap Counties. Dr. Locke provided information about the limited access to oral health services for Medicaid eligible residents in Jefferson and other counties. He reviewed the need for oral health services for children who may require anesthesia, how dental disease is one of the leading causes of emergency room visits and a contributor to other major health risks, treating oral health issues with an integrated approach, and the oral health project proposed under the Medicaid transformation initiative by the Olympic Community of Health (OCH). Dr. Locke noted that Jefferson Healthcare is expanding access by creating a first -of -its -kind rural health dental clinic and Peninsula Community Health Services in Kitsap County is considering a mobile operation to serve rural areas and long-term care facilities in Jefferson, Clallam, and Kitsap Counties. PUBLIC COMMENT Megan Selva of Nordland spoke of how difficult it is to find a dentist that accepts Apple Health. ACTIVITY UPDATE The Board discussed environmental public health code enforcement. There were no activity updates. AGENDA PLANNING CALENDAR Vicki Kirkpatrick, Public Health Director, said they will be seeking guidance from the Board in making financial decisions as they begin work on next year's budget. She hopes to discuss this at the next BOH meeting on June 21St A public hearing to amend the case scanning technology fee will be held at the next BOH meeting on June 21St NEXT SCHEDULED MEETING The next Board of Health meeting will be held on Thursday, June 21, 2018 from 2:30 — 4:30p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. Page 6 of 7 ADJOURNMENT Chair Austin adjourned the May 17, 2018 Jefferson County Board of Health meeting at 4:33 p.m. JEFFERSON COUNTY BOARD OF HEALTH Jo Austin, Chair Kees Kolff, Member �Q Kath een Kler, ember Uiesterman, Member Excused x Ariel Speser, Vice -Chair Kate De , Member Dav �atrl ader Respectfully submitted J. Matter Page 7 of 7